Healing Scents Article

7/27/2019 Healing Scents Article

1/8

AbstrAct

Individuals in emotional distress are often treated with psychothera-

peutic agents, but other treatment options exist. One safe and effec-

tive adjunct for the prevention and treatment of emotional distress is

aromatherapy. This article describes the physiological effects of scent,

reviews the research on aromatherapy, presents practical information

on the use of clinical aromatherapy for emotional distress, and sug-

gests resources for additional training and education.

46 JPNoNliNe.com


2/8

Individuals in emotional dis-tress are oten treated with

psychotherapeutic agents,but other treatment options exist

(Hogan & Shattell, 2007). Onesae and eective adjunct or

the prevention and treatment oemotional distress is aromathera-

py (Field et al., 2005; Kuroda etal., 2005; Lemon, 2004)thetherapeutic use o inhaled es-

sential oils. Aromatherapy is oneo the astest growing modalities

in complementary and alterna-tive medicine (CAM) in the

United States (dAngelo, 2002),but research on aromatherapy is

relatively scant, and ew nursingprograms oer courses in aroma-

therapy. This article describesthe physiological eects o scent,

reviews the research on aroma-therapy, presents practical inor-

mation on the use o clinical aro-matherapy or emotional distress,

and suggests resources or addi-tional training and education.

bAckground

The medicinal use o aromat-

ic oils extends back to ancientEgyptian and Chinese cultures

(Lis-Balchin, 2006), but the termaromatherapy was coined by Rene-

Maurice Gatteeosse, a Frenchchemist who experimented with

essential oils or wound healingduring World War I (dAngelo,2002). However, it was not until

the 1980s that aromatherapy be-gan to develop as a serious disci-

pline (Robins, 1999), when workon mind-body healing and the

emerging feld o psychoneuroim-munology stimulated interest in

the use o aromatherapy to allevi-ate emotional and mental distress

(dAngelo, 2002).Aromatherapy is currently

taught in French medical schools,prescribed by European physi-

cians, reimbursed by many Eu-ropean health insurers, and used

in Japanese actories to enhanceworker productivity and prevent

the spread o airborne inectiousdiseases (Robins, 1999). Aroma-

therapy is oten not prescribed bytraditional U.S. medical practi-

tioners; however, its use has in-creased among CAM and nursing

practitioners (dAngelo, 2002).

PhysiologicAl EffEcts

of scEnt

The sense o smell is crucial or

survival in mammals. Human be-ings have more than 1,000 dier-

ent genes that regulate the produc-tion o specialized receptors in the

nose (Buck, 2004). Each receptorcell is specifc and able to detect

only a ew molecule odors. Theresponses to an odor are neuro-

logically transmitted to the olac-tory bulb in the brain. There the

inormation rom several olactoryreceptors is combined, orming a

pattern that is perceived as a dis-tinct odor in multiple areas in the

cerebral cortex and the limbic sys-tem (Buck, 2004). Even though

JourNalof Psychosocial NursiNg Vol. 46, No. 10, 2008 47

Earn

4.0ContactHours


3/8

nasal receptors are quite specic,human beings are able to dieren-

tiate up to 10,000 odors through acomplex sensory-somatic cascade

that instantaneously activatesthe autonomic nervous system,memory, and emotion through

the amygdala and other limbicstructures (Buck, 2004).

Olactory stimulation causesimmediate physiological changes

in blood pressure, muscle ten-sion, pupil size, blink magnitude,

skin temperature, skin bloodfow, electrodermal activity, heart

rate, brain wave patterns, andsleep/arousal states (Kuroda et al.,

2005). Inhaled odors activate therelease o neurotransmitters such

as serotonin, endorphins, andnorepinephrine in the hypotha-

lamic pituitary axis and modulateneuroreceptors in the immune

system, altering mood, reduc-ing anxiety, and interrupting the

stress response (dAngelo, 2002).The sense o smell is related

to daily unctions such as alert-

ness, relaxation, attention, peror-mance, and healing, and these may

be mediated purposeully with di-erent aromas (Field et al., 2005).

Lavender, or example, has beenassociated with parasympatheticstimulation o the autonomic ner-

vous system, leading to increasedbeta power and decreased contin-

gent negative variation on electro-encephalogram; these in turn are

associated with decreased anxiety,improved mood, and increased

sedation (Moss, Cook, Wesnes, &Duckett, 2003). Peppermint and

rosemary have been associatedwith increased arousal, improved

cognition and memory, and en-hanced perormance on cogni-

tive assessment tests (Moss et al.,2003). The parasympathetic-stim-

ulating eects o lavender and thesympathetic-stimulating eects o

rosemary have been shown to sig-nicantly decrease salivary cortisol

and increase ree radical reactivescavenging activity, suggesting a

protective eect on the body rom

oxidative stress, as well as possibleanti-infammatory, anti-aging, and

anti-carcinogenic activity (Atsumi& Tonosaki, 2007).

These ndings on the physi-ological eects o scent in humanbeings suggest a link to emotions

and memory, both modulators ophysical and mental health. The

eect is immediate and worksbeyond the level o conscious

awareness (Moss et al., 2003).Thus, certain aromas may be used

to aect psychoneuroimmuneunctions to promote healing.

rEsEArch on

AromAthErAPy

Aromatherapy studies have

ocused primarily on the physio-logical and emotional arousal e-

ects o essential oils, which canbe inhaled, ingested, or applied

topically. Much o the researchhas evaluated aromatherapy in

conjunction with other modali-ties such as massage and refexol-

ogy (Buckle, 2007; Louis & Kow-

tAblE 1

EssEntiAl oil rEciPEs for EmotionAl distrEss

Issue Essential Oils Carrier Application

Anxiety, fear,

panic attacks

Sandalwood: 5 drops

Lavender: 5 drops

Bergamot: 2 drops

Inhaler tubea Inhale several times daily when

the feelings arise

Chronic worry,overthinking

Sandalwood 10 dropsLavender: 5 drops

Lemon: 3 drops

Inhaler tube Inhale several times daily

Depression Clary sage: 6 drops

Geranium: 6 drops

Lemon: 4 drops

4 oz spray bottle with

water

Spray face (eyes closed), chest,

and back of neck in the morning

and evening

Grief, shock,

depression

Rose otto: 6 drops

Clary sage: 5 drops

Lemon: 4 drops

2 oz unscented lotion or

jojoba oil

Apply to chest, stomach, and

lower back several times daily

Insomnia Bergamot: 2 drops

Lavender: 10 drops

Roman Chamomile: 5 drops

2 oz unscented lotion or

jojoba oil

Apply freely to chest and neck

prior to bed

Stress, tension Jasmine: 4 drops

Bergamot: 2 drops

Clary sage: 5 drops

2 oz bath salts (sea salts) Use 1 oz in one bath at night;

place in tub when water is full

aAn inhaler tube is a small plastic tube that comes with a cotton part onto which the oils are dropped. The oil-soaked cotton is then inserted

into the tube. The oils are inhaled through a small hole in the top of the tube. It also comes with a cover.

48 JPNoNliNe.com


4/8

alski, 2002). However, recentstudies have sought to isolate

the eects o aromatherapy as astand-alone therapy.

In a study o 73 healthy col-lege students, dierent scents

produced dierent mood statesollowing administration o an

anxiety-provoking task (Burnett,Solterbeck, & Strapp, 2004). Stu-

dents receiving inhaled rosemaryscored signifcantly higher on

measures o tension-anxiety andconusion-bewilderment than

did those in lavender and controlgroups. Both rosemary and laven-

der were signifcantly associatedwith lower atigue-inertia rat-

ings. The groups did not dier onphysiological parameters. These

results suggest dierences in theeects o aromatic oils on mood,

independent o physiologicallymeasurable parameters.

Evaluating the eect o aro-matherapy on crisis management,

Fowler (2006) ound that 77% oa convenience sample o 43 ado-

lescents in a residential mentalhealth acility asked or aroma-

therapy when they elt agitated.Fowler used a blend o 3% ylang

ylang, sweet marjoram, and berga-mot in jojoba oil, either inhaled ortopically applied using a modifed

hand massage technique. Duringthe 3-month study, the number o

pharmacological injections or agi-tation decreased rom 43 to 31, the

number o oral as needed medica-tions or anxiety or agitation de-

creased rom 631 to 397, and thenumber o seclusion and restraint

events decreased rom 29 to 20.In a convenience sample o 200

adults awaiting dental proceduresin Austria, those who received

diused ambient odors o orangeor lavender while waiting had sig-

nifcantly less anxiety and bettermood than did those exposed to

music or controls, even controllingor dental pain (Lehrner, Marwins-

ki, Lehr, Johren, & Deecke, 2005).However, among a convenience

sample o 118 patients awaiting

endoscopy in a same-day surgerycenter in the United States, no

signifcant dierence in anxietywas ound beore and ater laven-

der inhalation (Muzzarelli, Force,& Sebold, 2006). In this acute care

setting, mean anxiety scores wereextremely high both beore and

ater the intervention, suggestingthat aromatherapy may be better

or moderate anxiety than or se-vere anxiety. Even so, the authors

noted that anecdotal reports rompatients who received aromathera-

py suggested continued use o thismodality (Muzzarelli et al., 2006).

Louis and Kowalski (2002)examined physiological and

emotional parameters in a con-venience sample o 17 terminally

ill cancer patients ollowing treat-ment with humidifed lavender.

While physiological and psycho-logical scores improved in the

predicted direction, the dier-ences were not statistically signif-

cant, perhaps because o the smallsample. Interestingly, the patients

caregivers reported increases intheir own relaxation and sense

o well-being during the lavenderaromatherapy treatments.

Itai et al. (2000) compared theeects o lavender, hiba oil, andodorless conditions on depression

and anxiety in a group o 14 hemo-dialysis patients. Hiba oil signif-

cantly decreased mean scores onboth anxiety and depression, and

lavender signifcantly decreasedmean anxiety scores. The fnd-

ings were signifcant independento personality traits, psychologi-

cal status, and psychotherapeuticmedication or anxiety and sleep.

Lemon (2004) studied theeects o nine essential oils on

anxiety and depression in 32acute care psychiatric patients.

The study compared levels o de-pression and anxiety in a control

group receiving massage with car-rier oil and an experimental group

receiving essential oils diluted incarrier oil during massage. The

group receiving massage with es-

sential oils showed signifcantlymore improvement in scores on

depression, anxiety, and severityo emotional symptoms than did

those receiving massage alone.Clearly, the research contin-

ues to show mixed fndings onthe efcacy o aromatherapy.

This may be due, in part, to studylimitations, such as small and

convenience samples, one-timeor short-term interventions, and

methodological issues. However,even in those studies in which

aromatherapy interventions ailedto achieve statistically signifcant

improvements, continued use andstudy o this modality were en-

couraged by the researchers andparticipants (Louis & Kowalski,

2002; Muzzarelli et al., 2006). Sig-nifcant improvements were most

common in studies in which thearomatherapy was tailored to theclient by an experienced and ho-

listically trained aromatherapist(Itai et al., 2000; Lemon, 2004).

Buckle (2007) reported clinicallysignifcant fndings even in the

absence o statistical signifcancein many studies and noted that

institutional aromatherapy pro-grams have been implemented or

relaxation, emotional well-being,and agitation.

usE of clinicAl

AromAthErAPy

Eea o reeve

Ea de

Essential oils can be applied in

several ways. They can be addedto a carrier, such as a vegetable

oil or unscented lotion, and thenapplied to the skin, or they can be

added to bath salts, room sprays,



5/8

or diusers or inhalation. How-ever, the most eective applica-

tion route or decreasing anxietyand slowing an overactive mind

is inhalation. Using a small blankinhaler tube, essential oils are

added to a piece o cotton that isinserted into the tube. The oil isthen available to smell.

Oils used by aromatherapists toreduce anxiety, improve mood, and

reduce stress include (dAngelo,2002; Lis-Balchin, 2006):

l Bergamot (citrus bergamia).l Lemon (citrus limon).l Clary sage (salvia sclarea).l Lavender (lavandula

angustiolia).l Roman chamomile

(chamaemelum nobile).l Geranium (pelargonium

graveolens).l Rose otto (rosa damascene).l Sandalwood (santalum

album).l Jasmine (jasminum

ofcinalis).

The eects and dosing o thesenine essential oils are shown in

Table 1. Data on each o these oils,

including uses, side eects, precau-tions, chemical and botanical in-

ormation, and potential interac-tions can be ound in Lis-Balchins

(2006) aromatherapy text.

bg a sgEea o

Adulterated oils or oils that

are synthetic and calledragranceor perume oils will not oer the

same therapeutic eects as pureplant-extracted oils, and they

may actually cause allergies,headaches, and chemical sen-

sitivities. Gas chromatography(GC) and mass spectrometry

(MS) are methods o separatingcompounds in essential oils into

individual components and iden-tiying major components in the

oil. These processes are used toidentiy any adulteration o an

essential oil, which means the oilhas had chemicals or other sub-

stances added or removed. GC/MS testing is also used to identiy

the exact chemical profle o anoil and assess its potential thera-

peutic uses. The breakdown o

chemical components in individ-ual oils is important because some

o the therapeutic benefts o oilsare determined by their chemi-

cal makeup. Reports o chemicalcomponents should be available

to the buyer on request.Factors that cause oxidationo essential oils include exposure

to oxygen, heat, and light. Stor-age aects the shel lie o essen-

tial oils. When stored properly,their oxidation rate slows signif-

cantly. The potential or allergicreactions and skin irritation rom

essential oils increases when es-sential oils oxidize. Ideally, oils

should be stored in a dark, coolroom. Bottles should be dark-

colored glass. Shel lie can rangerom 1 to 8 years, depending on

the chemical makeup o the oiland the storage conditions. Han-

dling o oils and possible problemsin storage conditions are reduced

when there is only one companybetween distiller and customer, so

it is best to purchase essential oilsrom a company that buys directly

rom a distiller.

tAblE 2

AromAthErAPy And EssEntiAl oils rEsourcEs

Resource Type Organization Web Site

Organizations National Association or Holistic Aromatherapy http://www.naha.org

Publications Aromascents Journal(Canada) http://www.aromascentsjournal.ca

Aromatherapy Journal(United States) http://www.naha.org/journal.htmAromatherapy Thymes(United States) http://www.aromatherapythymes.com

Aromatherapy Today (Australia) http://aromatherapytoday.com

International Journal of Clinical Aromatherapy

(France)

http://www.ijca.net

International Journal of Essential Oil Therapeutics

(France)

http://www.ijeot.com

Aromatherapy education

and certication programs

The Aromahead Institute, School o Essential

Oil Studies

http://www.aromahead.com

The College o Botanical Healing Arts http://www.cobha.org

The Institute o Integrative Aromatherapy http://www.aroma-rn.com

R.J. Buckle Associates LLC http://www.rjbuckle.com

Essential oil distributors Aromatics International http://www.aromaticsinternational.com

Florihana Distillery http://www.forihana.com

50 JPNoNliNe.com


6/8

Pea

Like all medicinal products, es-

sential oils can be toxic or incom-patible with other compounds or

treatments, or they can produceside eects or cause allergic reac-

tions (Lis-Balchin, 2006). Whenrecommending a therapeutic regi-

men o essential oils or a client,the appropriate dosing, the route

o administration, and the clientssize, health status, and individual

preerences should be taken intoaccount (dAngelo, 2002). Side

eects can include exacerbationo asthma or respiratory disorders

due to allergen load, and withtopical application, contact der-

matitis or irritation. Also, particu-lar odors may be unpleasant or ir-

ritating to clients.Some oils, such as bergamot

or lemon, may cause photosen-sitivity. This can be avoided

by limiting sun and ultravioletlight exposure or 12 hours a-

ter use (dAngelo, 2002). Justas with allopathic medications,

certain oils are contraindicatedin certain health conditions,

including epilepsy (lavender,rosemary), hypertension (rose-

mary), asthma (rosemary), andpregnancy (lemon balm). Prac-titioners must practice in an

ethical and sae manner basedon proessional aromatherapy

and nursing guidelines (Buckle,2003; dAngelo, 2002).

AromAthErAPyEducAtion

Sae use o essential oils re-

quires an understanding o bota-ny, biochemistry, physiology, and

essential oil therapeutics, includ-ing dosing, administration, toxic-

ity, interactions, and side eects(Buckle, 2003). Essential oils can

be used by nurses, but advancedtraining should be obtained be-

ore clinical use. Continuing edu-cation programs in aromatherapy

can be ound through the Ameri-can Holistic Nurses Association

(AHNA) and the National As-

sociation or Holistic Aroma-

therapy (NAHA). A list o theseprograms is provided in Table 2.

Courses to obtain certifcation inaromatherapy are also available.

The NAHA (2005) has is-sued national educational stan-

dards or aromatherapy certifca-tion. To be certifed through the

NAHA, an aromatherapist musthave 200 hours o training rom

an approved school, which in-cludes courses in the chemistry,

botany, and anatomy and physi-ology o aromatherapy; the use oessential oils; extraction meth-

ods; oil quality and absorption;carrier oils; blending techniques;

methods o application; clinicaltherapeutics; and ethics. Aroma-

therapy texts (Buckle, 2003; Lis-Balchin, 2006) and a variety o

Internet resources available romAHNA and NAHA may also be

helpul to nurses interested in us-ing aromatherapy.

conclusionClinical aromatherapy shows

promise as a sae alternative or

complement to traditional healthcare interventions to relieve

stress, reduce anxiety, and im-prove mood; however, more re-

search is needed. Suggestions oruture research include interven-

tion studies that isolate the eects

o particular oils and combina-

tions o oils on mood, memory,and sense o well-being; replica-

tion studies using rigorous studydesigns and appropriate sample

sizes; studies on the use o aro-matherapy in various populations

(i.e., children, older adults, ethnicor cultural groups); and studies

that combine aromatherapy withguided imagery, meditation, or

hypnosis to augment the manage-ment o emotional distress.

The accessibility, low cost,and low side eect profle makearomatherapy attractive or man-

aging emotional distress. In ad-dition, its wide adaptability and

ease o use make it easy to tailorto diverse inpatient and outpa-

tient settings. Eective use re-quires adequate knowledge and

skills and the ability to saely tai-lor interventions to the unique

needs o each client. The art onursing requires a balanced and

integrative approach to healing.Aromatherapy is a healing prac-

tice that blends the essence oscience with the holism inherent

in the art o nursing.

rEfErEncEsAtsumi, T., & Tonosaki, K. (2007). Smell-

ing lavender and rosemary increases

ree radical scavenging activity and de-

creases cortisol level in saliva. Psychiatry

1. The medicinal use of aromatic oils extends back to ancient Egyptian andChinese cultures.

2. The sense of smell is related to daily functions such as alertness, relaxation,attention, performance, and healing, and these may be mediated purposefullywith different aromas.

3. Essential oils used to reduce anxiety, improve mood, and reduce stress includebergamot, lemon, clary sage, lavender, Roman chamomile, geranium, roseotto, sandalwood, and jasmine.

4. Effective use of aromatherapy requires adequate knowledge and skills and theability to safely tailor interventions to the unique needs of each client.

Do you agree with this article? Disagree? Have a comment or questions?

Send an e-mail to Karen Stanwood, Executive Editor, at [email protected].

Wee wag ea !

k E y P o i n t s



7/8

Research, 150(1), 89-96.

Buck, L.B. (2004). Unraveling the sense

of smell. Retrieved May 16, 2007,

rom the Nobel Prize Web site:

http://www.nobelprize.org/nobel_

prizes/medicine/laureates/2004/

buck-lecture.html

Buckle, J. (2003). Clinical aroma-

therapy: Essential oils in practice

(2nd ed.). New York: Churchill

Livingstone.

Buckle, J. (2007). Literature review:

Should nursing take aromather-

apy more seriously? British Journal

of Nursing, 16, 116-120.

Burnett, K.M., Solterbeck, L.A., &

Strapp, C.M. (2004). Scent and

mood ollowing an anxiety-pro-

voking task. Psychological Reports,

95,707-722.

dAngelo, R. (2002). Aroma-

therapy. In S. Shannon (Ed.),

Handbook of complementary and

alternative therapies in mental

health (pp. 71-92). San Diego,CA: Academic Press.

Field, T., Diego, M., Hernandez-Rei,

M., Cisneros, W., Feijo, L., Vera,

Y., et al. (2005). Lavender ra-

grance cleansing gel eects on

relaxation. International Journal

of Neuroscience, 115, 207-222.

Fowler, N.A. (2006). Aromatherapy,

used as an integrative tool or cri-

sis management by adolescents

in a residential treatment center.

Journal of Child and Adolescent

Psychiatric Nursing, 19, 69-76.

Hogan, B.K., & Shattell, M.M.

(2007). Fallout rom the bio-logical model: Implications or

psychiatric mental health nurses.

Issues in Mental Health Nursing,

28,435-436.

Itai, T., Amayasu, H., Kuribayashi,

M., Kawamura, N., Okada,

M., Momose, A., et al. (2000).

Psychological eects o aroma-

therapy on chronic hemodialysis

patients. Psychiatry and Clinical

Neurosciences, 54,393-397.

Kuroda, K., Inoue, N., Ito, Y., Ku-

bato, K., Sugimoo, A., Kakuda,

T., et al. (2005). Sedative e-ects o the jasmine tea odor and

(R)-(-)-linalool, one o its major

odor components, on autonomic

nerve activity and mood status.

European Journal of Applied Physi-

ology, 95, 107-114.

Lehrner, J., Marwinski, G., Lehr, S.,

Johren, P., & Deecke, L. (2005).

Ambient odors o orange and

lavender reduce anxiety and

improve mood in a dental ofce.

Physiology & Behavior, 86, 92-95.

Lemon, K. (2004). An assessment o

treating depression and anxiety

with aromatherapy. International

Journal of Aromatherapy, 14(2),

63-69.

Lis-Balchin, M. (2006). Aromather-

apy science: A guide for healthcare

professionals. London, United

Kingdom: Pharmaceutical Press.

Louis, M., & Kowalski, S.D. (2002).

Use o aromatherapy with hos-

pice patients to decrease pain,

anxiety, and depression and to

promote an increased sense o

well-being. American Journal of

Hospice & Palliative Care, 19,

381-386.

Moss, M., Cook, J., Wesnes, K., &

Duckett, P. (2003). Aromas o

rosemary and lavender essential

oils dierentially aect cogni-

tion and mood in healthy adults.

International Journal of Neurosci-

ence, 113, 15-38.

Muzzarelli, L., Force, M., & Sebold,M. (2006). Aromatherapy and

reducing preprocedural anxiety:

A controlled prospective study.

Gastroenterology Nursing, 29,

466-471.

National Association or Holistic

Aromatherapy. (2005). Standards

of training. Retrieved September

3, 2008, rom http://www.naha.

org/standards.htm

Robins, J.L. (1999). The science and

art o aromatherapy. Journal of

Holistic Nursing, 17, 5-17.

Ms. Butje is Clinical Aroma-

therapist; Aromatherapy Educator;

Essential Oil Importer; Owner, Aro-

mahead Institute (NAHA-approved

Aromatherapy Institute); and

Owner, Aromatics International

(International Internet store or

essential oils), Sarasota, Florida.

Ms. Repede is a doctoral student,

and Dr. Shattell is Assistant Proes-

sor, University o North Carolina

at Greensboro, School o Nursing,

Greensboro, North Carolina.

The authors disclose that

they have no signifcant fnancialinterests in any product or class

o products discussed directly or

indirectly in this activity, including

research support.

Address correspondence to

Mona M. Shattell, PhD, RN,

Assistant Proessor, University o

North Carolina at Greensboro,

School o Nursing, PO Box 26170,

Moore Building 320, Greensboro,

NC 27402; e-mail: mona.shattell@

gmail.com.

52


8/8

Healing Scents Article

Documents

Transcript of Healing Scents Article